Rippling only in one breast. Any suggestions?

Question

I have silicone under the muscle implants, I have lost weight and i have notice rippling in the inner side of my right breast. The left one does not have any rippling. Why am i only having rippling on 1 breast? Is the implant on right side getting more wrinkly than the implant on left side? If so why? I though both implants will age at the same rate. As well i would like to know if anatomical gummy bear implants can ripple too or if getting those will as assure being ripple free?

Larry S. Nichter, MD, MS, FACS · Answer

Breast Implant Rippling most often occurs when there is insufficient soft tissue coverage due to little overlying body fat and breast tissue. Implants placed beneath the muscle help to minimize this phenomena but the lower and outside breast (as pectoralis muscle is no longer present), towards the cleavage where the muscle thins out or on top of the breast where breast tissue is often lacking are the most common places to see rippling. It is often accentuated with certain positions (e.g. bending over,or leaning). Most of the time, rippling is felt along the outer side of the breast and the inner side of the breast next to the cleavage. Breast implant waviness (rippling) that is felt but not noticeable to the eye is very common and should not be a concern. However, when rippling is visible, patients are often self-conscious about their appearance.Factors that are associated with increased rippling include:Traditional Saline implants (IDEAL® Saline implants less likely)Textured implantsLarge implantsThin patients with low BMIImplants placed above the musclePrior history of ripplingFactors which are less likely to have rippling include:Heavier and larger breasted womenUsing a highly cohesive form-stabile silicone implants (gummy bear)Smooth implantsSmaller implantsSubmuscular placementOnce rippling occurs it is very difficult to correct. Rippling can be minimized by placing a biologic fabrics (e.g. AlloDerm®, Strattice™, SERI®), submuscular conversion if implants are above the muscle, fat transfer, use of adjacent tissue (muscle or fascia) if available, and in persistent cases implant removal and fat transfer. Seek the care of the best board certified plastic surgeon possible with experience in breast revision surgery.#rippling#breastaugmentation

Young R. Cho, MD, PhD · Answer

Thank you for your question. Rippling can be seen when the surface of an implant shadows through the tissue, often found where the breast tissue coverage is thin. It can happen in one or both breasts. Some implant styles are more prone such as an overfilled saline implant. Others are less prone such as a shaped silicone implant. So one approach is to change an implant to one that is less prone to rippling. Another approach would be to add some thickness to the breast tissue. This can be done by fat grafting where fat is carefully layered between the skin and the implant. Another is to add a dermal matrix sheet between the breast and the implant where the rippling is visible to blunt the impression of the implant on the overlying skin. I would visit with a board certified plastic surgeon to discuss your options in more detail.

Aldo Guerra, MD · Answer

Hello 12322. Thanks for your post. All breast implants ripple, even the anatomic or tear drop shape. When I see this situation in my office, I ask the patient to gain some weight back. That seems to work really well. If that's not an option, then I offer them fat injections to the area of concern. That has also been very effective in my hands. Best wishes, Dr. ALDO.

Vincent N. Zubowicz, MD · Answer

Just by chance rippling might be worse on one breast and the other. Silicone gel implants have a lower incidence. If you have texturized implants because they have a higher incidence of rippling you may want to switch to the smooth variety.

Darryl J. Blinski, MD · Answer

Few issues. No posted photos so can not really respond. Timing after the operation was not stated. Silicone rounds have less ripples than other styles. Best to see your operative surgeon for examination in person...

Thomas M. DeWire Sr., MD (retired) · Answer

12322,All implants ripple to some extent, with the only question being whether or not the rippling is perceivable.  It may be harder to feel or see the rippling with smooth silicone than with smooth saline implants, but in thin enough patients, or with large enough implants, the soft tissue coverage becomes inadequate to hide the rippling that has been there all along.  Textured implants, silicone or saline, tend to have the greatest chance to show rippling because the implant surface tends to stick to the internal capsule scar, pulling the overlying tissues as the implant moves, and transmitting ripples to the surface, but again one needs to be thin enough to see this.  No implant can offer assurance of no detectable rippling, however stiffer silicone implants may ripple less, but then become progressively too firm to the touch losing the softness benefit.  Your appearance of rippling is likely associated with your stated weight loss, but location of the implants is also important, with implants over the muscle tending to show rippling much more readily than those under the muscle. You state that you have implants under the muscle, but appearance of medial rippling in that instance may be associated with medial muscle release, or asymmetrical partial release of the medial muscles, neither of which are necessarily good technical maneuvers, and may produce asymmetries, or later problems associated with loss of muscle boundaries and muscle support.   This rippling appearance does not necessarily indicate anything is wrong, however.  I hope that this helps.  General information is found at the link that follows.

Rippling only in one breast. Any suggestions?

Answers (6)

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